Health Equity blog

A recent article published by Kaiser Family Foundation (KFF), reports that CMS has ordered states to investigate whether their Medicaid programs are providing benefits to individuals whose immigration status renders them legally ineligible. Medicaid is only available to U.S. citizens and some lawfully present immigrants. In August, CMS began sending state Medicaid agencies the names of enrollees who it suspected may be ineligible, requesting verification of such individuals’ immigration status. Some states have objected to CMS’s demands, claiming that the federal government’s projected figures of ineligible recipients are overstated for several reasons, including misidentification, and that these latest efforts are duplicative of eligibility verification processes already in place, not to mention inadvertently excluding eligible individuals due to such administrative challenges as missing paperwork.

KFF recently reported that U.S. Department of Health and Human Services’ Office of Population Affairs (OPA) has largely ceased operations following federal layoffs. OPA administers the Title X family planning program, which provides contraception, pregnancy testing, and other primary and preventive care to almost 3 million low-income or uninsured patients annually. These developments, combined with recent Medicaid reductions, the potential lapse of Affordable Care Act (ACA) premium subsidies, and funding cuts across the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) programs, have raised concerns about the long-term stability of the reproductive health safety net.

On Nov. 10, the Food and Drug Administration (FDA) announced plans to revise labeling for hormone replacement therapy (HRT) products used to treat menopause. The agency will remove boxed warning references to cardiovascular disease, breast cancer, and probable dementia, citing updated evidence that these risks were overstated in earlier studies. However, the FDA is leaving in place the boxed warning for endometrial cancer for systemic estrogen-alone products. According to the FDA, these changes are intended to reflect current science and support informed decision-making for women considering HRT.

September 4, the U.S. District Court for the Northern District of Georgia issued a preliminary injunction that partially blocks enforcement of a state law that went into effect in May 2025. This law was intended to prohibit “controversial procedures,” including surgical, hormone or cosmetic procedures to treat gender dysphoria, being performed on inmates. The preliminary injunction pertains to the provision of hormone therapy, and orders the continued provision of hormone therapy and evaluations for hormone therapy. In issuing the preliminary injunction, the court concluded that the state law likely violates the prisoners’ Eighth Amendment right against cruel and unusual punishment.

A recent study published by The Commonwealth Fund found that work mandates for Medicaid beneficiaries in states that expanded Medicaid eligibility under the Affordable Care Act (ACA) will have significant adverse financial impacts on hospitals, particularly safety net institutions. Specifically, individuals who fail to comply with work obligations risk losing Medicaid coverage, which could drastically increase the percentage of patients who are uninsured and erode already thin hospital operating margins.

In response to the current Administration’s efforts to rollback publicly available federal data, the Kaiser Family Foundation warns that removing such data, particularly the removal of sociodemographic variables from such datasets, will have dire consequences for health care equity-related initiatives in addressing health care disparities across sociodemographic factors such as race, ethnicity, and sexual orientation/gender identity.

In connection with the ongoing federal government shutdown, the majority of Department of Education (ED) personnel responsible for overseeing the special education needs of children with disabilities have been laid off. Several ED offices provide collective oversight and monitoring of states’ compliance with the Individuals with Disabilities Education Act (IDEA), which guarantees all children with disabilities the right to a free and appropriate public education.

The Centers for Disease Control and Prevention (CDC) has revised its immunization schedules to emphasize individual decision-making for COVID-19 vaccination, and to recommend that toddlers receive protection from chickenpox as a standalone immunization instead of in combination with measles, mumps, and rubella (MMR) vaccination. The CDC’s revised schedules reflect changing policy that supports clinical decision-making based upon individual patient characteristics that are difficult to incorporate in broad-based recommendations, including risk factors for the underlying disease, the characteristics of the vaccine, and the best available evidence of which patients may benefit from vaccination.

A recent study published in Health Affairs reveals that Black, Hispanic, and Asian adults in the U.S. have significantly lower rates of engagement with each step of the “naloxone care cascade” compared to White adults. This cascade is a framework encompassing awareness, access, training, possession, and use of naloxone to counteract opioid overdoses. This research calls out a need for culturally tailored and equity-focused strategies that address the systemic causes of racial and ethnic disparities in naloxone engagement.

The California Dental Association (CDA) and its affiliated Foundation released their Health Equity Report in early September (announcement can be found here). The Report examines the challenges to oral health equity and suggests strategies to support recruitment and retention of dental professionals from underrepresented backgrounds. The goal is to reduce disparities in oral health outcomes by increasing the diversity of dental professionals who are more representative of California’s populace. The Report is in furtherance of the CDA’s and its Foundation’s 2022 policy aimed at “reinforcing its commitment to expanding care for underserved communities and improving diversity within the dental profession.”